Health Claims Specialists
Company Description
This is a full-time permanent healthcare claims adjudicator position. A claims adjudicator determines how much money will be paid after an insurance claim has been examined. This is not a customer service or customer facing position. This is a data entry position where you will be processing medical claims per the specific client requirements. Claims can vary and are highly customized depending on the service level. You will work independently with the assistance of knowledge base and support personnel. You will also be expected to meet all Key Performance Indicators and Quality goals throughout Training and beyond.
Job Description
What you will be doing as a Claims Examiner:
- Work independently, processing claims via data entry for 90% of your day.
- Be responsible for effectively adjudicating claims to meet production, quality, and other metrics in accordance with policy/procedures and regulatory guidelines
- Follow up on claims needing additional information
- Refer problem claims to a Lead and/or auditor for additional review
- Make sure that the integrity of the information is accurate and kept private according to HIPPA guidelines
- Work with specific software
- May be assigned special projects
When you join us, you’ll enjoy:
- Pay rate of $13.50/hour with the opportunity to bonus an additional $1500 a month.
- Medical, dental, and vision plans.
- Paid training and PTO (be sure to ask about our Global Flexible Vacation Policy).
- Company-provided equipment.
- Advancement opportunities – 80% of our frontline leaders have been promoted from within.
- Monthly rewards & recognition programs.
- Employee Discounts.
- EAP and Health and Wellness programs including a personal trainer dedicated to Sutherland.
- Weekday schedule, Monday – Friday 8:30 AM – 5:00 PM EST.
Qualifications
Skills
- Data entry
- Time management
- Attention to detail
- Analytical
Required Qualifications
- High School Diploma or equivalent
- Excellent Internet Connectivity:
- Internet access speed of 2 Mbps upload and 10 Mbps download – the faster the better.
- house network, and a hard-wired internet connection capable of continuously supporting outstanding call quality and high-speed response rates. (Wireless and/or satellite Internet Service Providers are not compatible with our systems)
- A quiet and distraction-free, secure place to work
- Effective verbal and written communication skills
- Strong typing and analytical abilities
- Multi-tasking skills with a strong attention to detail
- Computer knowledge
- Minimum 40 words per minute on typing test
- Must have and maintain a clean and paper free work environment to meet our company policies.
- Medical Billing and Coding degree/certification.
- Previous experience in a medical office type setting, including some knowledge of insurance, claims, billing or coding, with an understanding of the different types of insurance (Medicare/Medicaid and/or Child Plus).
- Knowledge of Medical terminology
Additional Information
All your information will be kept confidential according to EEO guidelines.
#INDSP
EEOC and Veteran Documentation
During employment, employees are treated without regard to race, color, religion, sex, national origin, age, marital or veteran status, medical condition or handicap, or any other legally protected status.
At times, government agencies require periodic reports from employers on the sex, ethnicity, handicap, veteran and other protected status of employees. The purpose of this Administrative EEO Record is for statistical analysis only and is used to comply with government record keeping, reporting, and other legal requirements. Periodic reports are made to the government on the following information. The completion of the Administrative EEO record is optional. If you choose to volunteer the requested information, please note that all
Administrative EEO Records are kept in a Confidential File and are not part of your Application for Employment or Personnel file.
Please note: YOUR COOPERATION IS VOLUNTARY. INCLUSION OR EXCLUSION OF ANY DATA WILL NOT AFFECT ANY EMPLOYMENT DECISION.
Average salary estimate
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Are you ready to take the next step in your career as a Health Claims Specialist with us in Louisville, KY? This full-time permanent position offers an exciting opportunity to play a crucial role in the healthcare sector. As a Health Claims Specialist, you will be primarily processing medical claims and determining the payment amounts after thoroughly examining the insurance claims. Forget customer service; this is a behind-the-scenes role where your keen attention to detail and analytical skills will shine! Your daily routine will consist of data entry for about 90% of your time, ensuring that each claim meets our established production and quality metrics, all while adhering to policy, procedures, and regulatory guidelines. You will work independently, tapping into a comprehensive knowledge base and support personnel whenever needed. With a pay rate starting at $13.50/hour and the potential for an additional $1500 in monthly bonuses, this position is not just about the numbers. It's also about enjoying a supportive work environment that fosters personal and professional growth. We value our team's dedication, providing benefits like medical, dental, and vision plans, paid training, and even monthly recognition programs. Our employees have the chance to advance, as 80% of our frontline leaders have climbed the ranks from within. Join us in a weekday schedule that allows you to maintain a healthy work-life balance while impacting the healthcare landscape positively. If you're equipped with a Medical Billing and Coding degree, enjoy working independently, and thrive in a detail-oriented environment, you could be the ideal fit for our team here in Louisville!
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